Managing Menopause

As little as fifty years ago, this title would have been useless. Nobody needed menopause management!

The "why" is crucial for today's women to understand.

As an example:
My grandmother died in her sleep the month before I was born, in 1945. She was forty-three years old! Now, I can look at photographs of her, and I actually have her medical history through stories that my mother told me. What I surmise is that she had some hormonal/insulin disorder (she had multiple miscarriages and her body appears to have had the characteristics of what we call polycystic ovarian syndrome today). Contemporary research has found the connection between these disorders in younger women and subsequent cardiac dysfunctions in midlife. In one study, virtually 100% of women developed cardiac disease within the 17 years of the study.

We did not need menopause management before because EVERY woman either died at an early age or developed into an "old" woman with old lady characteristics. I look at photographs of my mother at my age; she looked like an old woman. On the other hand, when people guess my age, they often miss it by as much as 15 to 18 years. Part of this generational difference results from better healthcare, more knowledge. In addition, there are cultural expectations of what aging should be. And there is more to the story than what appears at first glance.

Menopause management begins with the onset of menarche when a woman is 12 and persists across her developmental lifespan. What this means is that every reproductive and health choice a woman makes influences what her menopause will be. As a practical matter, the way in which a woman's menstruation cycles begin, and how that beginning is managed, determines what her reproductive choices, hormonal choices, and relationship choices across a lifespan will be. And fundamentally, how a woman learns in adolescence to approach her body, her wellness, her health, her spirituality, and the risk-taking behaviors she has, what she exposes herself to or protects herself from, what options she exercises to nourish and enrich in herself in terms of mind, body, and spirit, ultimately determines what her menopause will be.

So, those of us who are trailblazing need to be teaching this concept to every young woman we meet-our daughters, our nieces, our best friend's daughters, our sons' girlfriends. However, most women do not think this way, and so in the perimenopausal stage, hormonal changes affect their relationships and their bodies, and they come to this place in the lifespan and begin asking, "What is my purpose in life? What is the meaning of my existence? Did I really want to be with this partner and now am not certain I want to be with them;" we are bewildered and wonder why. Each woman is so individual, and if she has struggled across her lifetime and still has not resolved hormonal/menstrual/relationship issues, then she can expect to have a difficult menopause. Menopause continues for about 15 years if viewed properly. It recapitulates the options we face in adolescence and is a developmental process that prepares us for the last half of life similar to the way in which adolescence prepares us for the first half of life.

I had a patient in my office this morning who said, "I don't know what to do; there are conflicting ideas about treatment and care. One person will say one thing and someone else will say the exact opposite." She is right..I have had patients who have gone for therapy, and the counselor told them to take an herbal combination that will make them feel better for a while but which can then cause them damage because there was no understanding of the physiology of midlife. This particular patient would have, within months, developed cardiac complications based on the combination of herbs she was taking and the hormone levels in her blood. The great majority of people who tell people to take herbs do so because they have studied herbs, not because they know anatomy and physiology. The chemistry of climacteric is delicate and complex. It requires blood tests and medical records reviews (both for men and women!!!) and an individually developed treatment protocol.

I try to remind people of this one fact in herbal lore: Hemlock is a plant. We act as if because it is plant-based, it is safe..plants can kill. Anyone prescribing herbs should know allopathic medicine and healthcare as well as their herbs and be able to order the appropriate blood tests to confirm the correctness of the treatment. If your practitioner cannot do both..you need to be somewhere else!

Many women are now seeking alte
atives to the traditional throw-a-hormone-from horse-urine-replacement-at-her-menopause! Wow! And it feels like this. The stats are high: Nearly 75% of women stop hormone management in the first 6 months of beginning because their bodies feel so awful, not to mention what happens to their psyches and relationships. Women are living longer and this generation of midlife women is blazing the trail for women to follow. We are changing how women are seen, what our expectations of life are, and what our health caring is. It is crucial for us to have the very best in holistic healthcare possible and the education necessary to make informed decisions about our bodies/minds/relationships. nnn